Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 190010 | NC |
NPI | 1144531591 |
---|---|
Provider Name | Dr. Eric Sharp Burgon |
First Address | Chapel Hill, NC 27599-0001 |
Second Address | Chapel Hill, NC 27599-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2010 |
Last Update Date | 28/01/2015 |